Gilmoor Andrew Roderick, Adithy Adithy, Regeer Barbara
Athena Institute for Research on Innovation and Communication in Health and Life Sciences, VU University Amsterdam, Amsterdam, Netherlands.
Private Practitioner, Pune, India.
Front Psychiatry. 2019 Jul 4;10:439. doi: 10.3389/fpsyt.2019.00439. eCollection 2019.
The cross-cultural validity of the construct of post-traumatic stress disorder (PTSD) has been a life-long debate in the field of trauma. Its validation in a setting such as India-a nation prone to considerably traumatic events such as conflict, natural disasters, and sexual violence against women-warrants exploration. To describe how PTSD and post-traumatic stress symptoms (PTSS) are conceptualized in the Indian context by systematically examining the evidence of studies that investigate PTSD and PTSS in India. A systematic search in PubMed, Web of Science, and Science Direct yielded a total of 56 studies that discussed one or multiple aspects of PTSD and PTSS in India. Data relating to types of events, populations, diagnostic tools, manifestations, and interventions were extracted and analyzed. Eleven of 29 Indian states and 2/7 union territories were represented in the 56 included studies, with most studies (n = 21) originating from Tamil Nadu. Natural Disasters (n = 28), War/Conflict (n = 10), and Medical conditions (n = 7) were the top three most commonly investigated traumatic events. The majority of studies focused on entire communities (n = 16), while children and adolescents made up the second largest group (n = 14). Less attention was paid explicitly to male (n = 3) or female (n = 4) victims. Twenty-five different methods for screening for PTSD were identified, with the most common being the impact of events scale (n = 14). The majority of studies reported the screening and clinical diagnosis of PTSD by professional health care providers (n = 24). Abuse scored the highest average prevalence of PTSD at 52.3%, while the lowest was 16.4% due to man-made accidents. Overall, there was a lack of assessment on trauma-specific interventions, though psychosocial support was the most commonly mentioned intervention. Results indicate diversity in approaches for identifying, measuring, and treating PTSD and PTSS in the Indian population and how sociocultural norms influence its manifestation in this population. Future research calls for the development of culturally sensitive approaches to identifying and addressing PTSD and PTSS in India.
创伤后应激障碍（PTSD）这一概念的跨文化有效性在创伤领域一直是个长期的争论话题。在印度这样一个容易发生大量创伤性事件（如冲突、自然灾害以及针对女性的性暴力）的国家对其进行验证很有必要。通过系统审查在印度调查PTSD和创伤后应激症状（PTSS）的研究证据，来描述在印度背景下PTSD和PTSS是如何被概念化的。在PubMed、科学网和科学直投数据库中进行系统检索，共得到56项讨论印度PTSD和PTSS一个或多个方面的研究。提取并分析了与事件类型、人群、诊断工具、表现和干预措施相关的数据。纳入的56项研究涵盖了29个印度邦中的11个以及7个联邦属地中的2个，大多数研究（n = 21）来自泰米尔纳德邦。自然灾害（n = 28）、战争/冲突（n = 10）和医疗状况（n = 7）是最常被调查的三大创伤性事件。大多数研究关注的是整个社区（n = 16），而儿童和青少年构成了第二大群体（n = 14）。对男性（n = 3）或女性（n = 4）受害者的关注较少。共确定了25种不同的PTSD筛查方法，最常用的是事件影响量表（n = 14）。大多数研究报告称由专业医护人员进行PTSD的筛查和临床诊断（n = 24）。虐待导致的PTSD平均患病率最高，为52.3%，而人为事故导致的最低，为16.4%。总体而言，尽管心理社会支持是最常被提及的干预措施，但对创伤特异性干预措施缺乏评估。结果表明，在印度人群中识别、测量和治疗PTSD及PTSS的方法存在多样性，以及社会文化规范如何影响其在该人群中的表现。未来的研究需要开发对文化敏感的方法来识别和解决印度的PTSD和PTSS问题。
